Temporal trends in permanent pacemaker implantation: A population-based study - 09/08/11
, Imad M. Tleyjeh, MD b, Larry M. Baddour, MD c, Paul A. Friedman, MD d, Sarah M. Jenkins, MS e, Jennifer L. St Sauver, PhD e, David L. Hayes, MD dRésumé |
Background |
Limited data exist regarding temporal trends in permanent pacemaker (PPM) implantation. To describe trends in incidence and comorbidities of PPM recipients, we conducted a retrospective population-based cohort study over a 30-year period.
Methods |
All 1291 adult residents of Olmsted County, Minnesota, undergoing PPM implantation between 1975 and 2004 were included in the study. Trends in PPM implantation incidence, pacing mode and indication, and comorbidities (via Charlson Comorbidity Index [CCI]) were assessed through the Rochester Epidemiology Project. Permanent pacemaker recipients were compared with age- and sex-matched PPM-free controls from the population.
Results |
Adjusted implantation incidence rates increased from 36.6 per 100 000 person-years during 1975 to 1979 to 99 per 100 000 person-years during 2000 to 2004 (P < .0001). After adjusting for age (hazard ratio [HR] 1.06 per year), male sex (HR 1.28), and implant year (HR 0.98), the HR for death among PPM recipients by CCI quartiles was 1.0, 1.79, 2.29, and 3.91 for CCI of 0 to 1 (reference), 2 to 3, 4 to 6, and ≥7, respectively (P < .0001). Overall, PPM recipients had higher CCI than the population-based controls (P = .04), with higher mean CCI noted since 1990. Mean age-adjusted CCI increased from 3.15 to 4.60 among the cases (P < .0001) and from 3.06 to 3.54 among the age- and sex-matched controls (P = .047).
Conclusions |
There have been significant increases in incidence of PPM implantation over 30 years, and PPM recipients have had an age-independent increase in comorbidities relative to the underlying population, especially over the past 15 years.
Le texte complet de cet article est disponible en PDF.Plan
| This article was presented, in part, at the American Heart Association Scientific Sessions, November 2006, Chicago, Ill (Abstracts 3877 and 3878). This study was supported by the Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minn. The division had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Dr Uslan and Ms Jenkins had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. |
|
| Author disclosures are as follows: DZU, TyRx Pharma, Pfizer, Cubist (honoraria/consulting); LMB, Elsevier, UpToDate (Royalty payments), American College of Physicians and Physicians' Information and Education Resource (PIER) (editorial consultant); PAF, Medtronic, Guidant, Astra Zeneca (honoraria/consultant), Medtronic, Astra Zeneca via Beth Israel, Guidant, St Jude Medical, Bard EP (sponsored research), Bard EP, Hewlett Packard, Medical Positioning, Inc (intellectual property rights); DLH, Medtronic, Boston Scientific, St Jude Medical, Sorin/ELA Medical (honoraria), St Jude Medical, Sorin/ELA Medical, AI-Semi (advisory boards or committees), St Jude Medical and Medtronic (steering committee), Visible Assets (sponsored research). |
Vol 155 - N° 5
P. 896-903 - mai 2008 Retour au numéro
Article précédent
- Optimal heart failure therapy and successful cardioversion in heart failure patients with atrial fibrillation
- Leif-Hendrik Boldt, Sascha Rolf, Martin Huemer, Abdul Shokor Parwani, Friedrich C. Luft, Rainer Dietz, Wilhelm Haverkamp
- The economic consequences of non–evidence-based clopidogrel use
- Niteesh K. Choudhry, Raisa Levin, Jerry Avorn
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?